Oncology Value-based Care
Transforming Oncology Care with Precision and Value
Empowering oncologists to deliver superior outcomes at lower costs with OMI’s Value-Based Care Solution
Improved Clinical Outcomes
Significant Cost Savings
Aligned Provider Incentives
Oncology in Numbers
1 in 8
Women will develop breast cancer in their lifetime
313,510
Estimated new breast cancer cases in 2024
15.5%
Of new female cancer diagnoses are breast cancer
19.1
Breast cancer deaths per 100,000 women
85%
Of total cancer spend is from just 17 cancer types
$29.8B
Annual breast cancer treatment spend
$9.7B
Spent under Medicare – Part B
71.1%
Of Part B breast cancer spend is for injectables
Oncology Program Objectives
Clinical
Precision Medicine
Utilizing collected detailed Clinical Elements to present all medically acceptable Treatment Plans at the point of care along with associated costs.
Quality Thresholds and Metrics Reporting
Measure and report on Eligible Members’ Quality Thresholds and Metrics to demonstrate that selected Actual Treatment Plans do not have an adverse impact on patients.
Satisfy Value-Based Care Requirements
Allows payers to include enhanced performance reporting for both financial and quality metrics that are governed by officiating bodies as a requirement of a contract.
Financial
Cost of Care Reduction
When clinically appropriate, reduce unnecessary treatment costs for newly diagnosed patients with breast cancer stages I – III.
Guaranteed Margins
Ensure that providers maintain financial stability during the transition to value-based care by ensuring they do not experience any loss of margin as a result of participating in the Program.
Shared Savings
Implement Shared Savings models that benefit the payers, providers, and Eligible Members/Attributed Members.
Driving Value with the OMI PULSE Platform
OMI bridges the gap between clinical quality and financial efficiency by equipping Oncologists with real-time data and actionable insights through our proprietary platform, OMI PULSE.
How it Works
Collection of Clinical Elements
OMIC Generation
Action Code Bridge
Pathway Selection
Reduced Cost of Care
Intervention Strategy
The primary objective of the intervention is an appropriate reduction in one (1) year cost of care for newly diagnosed breast cancer Eligible Members, in stages I – III, while maintaining or improving clinical outcomes.
Methodology
Patient Codification
The OMI PULSE platform, powered by RoseTraTM, digitally codifies Eligible Members into disease specific cohorts based on Clinical Elements.
Treatment Plan Matching
Eligible Members are matched to relevant Treatment Plans, presented to providers through OMI PULSE, at the point of care.
Cost Transparency
OMI PULSE supplies providers with the relevant Treatment Plans’ one (1) year cost.
Treatment Flexibility
Medication Exchange/Substitution
Adjust medications to more cost-effective alternatives without compromising the quality of care.
Dose Tapering
Appropriately reduce medication doses or altering interval to minimize costs and side effects while maintaining efficacy.
Place of Service Modification
Shift care to the most cost-effective yet appropriate settings.
Treatment Plan Selection
Presentation of all the respective medically acceptable guidelines for a diagnosis. Treatment Plans are then displayed in OMI PULSE.